Random thoughts from a few cantankerous American physicians. All contributors are board certified. Various specialties are represented here. I do not know where this will lead but hope it will at least be an enjoyable read. All of the names mentioned in this blog are pseudonyms, the ages have been changed, and in half the cases the gender as well. All photographs are published with patient consent or are digitally altered to preserve anonymity. Trust us, we're doctors.

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Monday, April 26, 2010

A few weeks ago, a man came to the ER complaining of left flank pain. The guy seemed to be in obvious distress and from the 100 yard glance I diagnosed a kidney stone. He was one of those patients who wouldn't listen to much of anything I had to say and seemed to think that I walk around the ER with syringes of drugs in my pocket.

Despite my best efforts to be nice and explain what I thought was going on, he was oblivious. Realizing that I was wasting my time, and bored with his attitude and IQ somewhat above a turnip (I'm not being elitist, he really was stupid), I turned to leave.

That's when he became interesting! "I get these 'kidney stones' all the time, but I'm usually able to dig 'em out with a spoon. But I couldn't get this one!" he exclaimed. NOW, he had my undivided attention. "You stick a spoon up your penis?" I asked. Seeing his quizzical look, I rephrased the words so that he would understand. "No, I stick it up my ass and pull 'em out." he informed me (and then he looked at me like I was an idiot).

I asked if that usually worked and he informed me that it almost always did. When it did not, he informed me that was able to stick his finger (or 'fanger' as he called it) down his throat and "throw them up". Fortunately, that worked for him the rest of the time! In fact, this was the first time he had EVER had to come to the ER for one of his "kidney stones", and he said that he usually got three or four a week!

The work up revealed that on this occasion at least, he DID have a kidney stone (and the CT showed NONE remaining in either kidney. I have no idea what he had the other times! The nurse, who was new to ER medicine asked me if I was going to explain the anatomy to him before he left, but I declined (deeming the endeavor futile). I however, delegated the task to her. After about 15 minutes, she exited the room completely frustrated and disillusioned.

The patient passed the stone, and I chalked up another save!

And to the Anonymous poster who continues to question whether we're physicians or not.... I have this guy's address and he'd like to have you over to his house for a bowl of soup. Don't bring your own spoon. He has plenty.